Philadelphia is initiating a wonderful (but probably illegal) program that is the best hope for finally controlling our out-of-control and progressively more lethal opioid epidemic.
The pioneering US city will adopt an effective harm-reduction method that has for decades been widely used in many other countries with more rational drug policies and politics.
“Safe Houses” will be established where addicts will be supplied free clean needles, medical care should they overdose, and social services. The safe house approach has the immediate benefit of reducing death, crime, and the spread of infectious disease.
More long term, many addicts attracted to the program can then be gradually be weaned from injecting lethal street drugs to safer modes of administration and the use of safer medication substitutes. Some may eventually decide to participate in more ambitious rehab treatments. And many of the homeless and unemployed will benefit from the social workers who will assist their re-entry into society.
If anything, the Philadelphia program is a too timid, partial approach. It would have a greater, and faster, effect if the safe houses were also allowed to provide free heroin.
Fighting The Fentanyl Challenge
There has never been a more dangerous time to buy street drugs.
Fentanyl is by far the most deadly killer drug ever- fifty times more potent than heroin and often (without buyers’ or sellers’ knowledge) contaminating what is sold as much less lethal run-of-the-mill heroin or other street drugs.
Fentanyl is so cheap and easy to produce, and so compactly convenient to smuggle, that it will always defy law enforcement interdiction. Since we can never possibly control the supply side, the only way to reduce exposure to deadly fentanyl is to allow access to the lesser evil of free heroin.
Protecting addicts from the random lethality of street fentanyl would be the single biggest and fastest contribution to containing the exponentially growing loss of life caused by our opioid epidemic.
More long-term, it will be crucial that we take an entirely different approach to the “war-on-drugs”. As a cornerstone of our drug policy for the last fifty years, interdiction has failed miserably. The potency of fentanyl in small packages now makes interdiction even more ridiculously impotent. We must pivot rapidly from failed supply-side interdiction to promising demand-side treatment and harm reduction.
The only rational policy is to end our failed prohibition ideology and replace it with free treatment for all addicts- funded by government and drug company fines. No one would then ever have to resort to buying a potentially lethal street drug, because desired drugs would be freely available in the treatment programs.
Why Is Philadelphia’s Plan Illegal?
In June 1971, President Richard Nixon set in motion the remarkably dumb and ineffective war on drugs- using cops, border patrols, courts, and prisons as weapons.
Some fifty years on, Trump is very much in the Nixon mode. Old habits die hard. His Justice Department has reversed many of the more enlightened drug policies introduced by President Obama and has reverted to the get tough, law and order policies that have failed badly, but play well to the base.
In this spirit, the Trump Justice Department is now suing and trying to close down the promising Philadelphia program. It derisively describes the program as equivalent to a crack house and declares it to be in violation of federal law, citing the Controlled Substances Act which makes it illegal to run a facility that knowingly distributes illegal drugs.
Clearly the law needs to be changed immediately to allow for treatment programs designed to make safer the use of illegal drugs. And in the future, let’s hope that our country eventually becomes mature enough to decriminalize drug use altogether and substitute instead a policy that emphasizes treatment and harm-reduction.
The program has wide local support in Philadelphia. It is seen as an essential step in the opioid deaths haunting the city. The city’s legal defense will be that local governments must have the right to experiment with new ways of meeting the opioid epidemic- since the old ways have failed and the federal government has provided no answers and little funding support.
Insanity has been described as doing the same dumb thing over and over again, always expecting a different outcome. By this definition, our draconian drug policies are clearly insane. The Philadelphia harm-reduction program provides a crucial test case to determine whether our country can become more flexible in our drug policies. Will we continue to allow a paralyzed and paralyzing federal bureaucracy and legal system to remain stuck on failed policies? Or will we allow 100 flowers of local experiments to bloom. Unless we change our ways, the fentanyl epidemic can be expected create ever-increasing death and destruction.